Pay and Practice: Show Me the Cost!

Pay and Practice is a blog by David Pittman for readers with an interest in health policy.

Despite calls for physicians to be conscious of the cost of care they deliver and the need for medical educators to provide training for this, less than 15% of internal medicine residency programs have a formal curriculum on the topic, research found.

Of 261 residency program directors to complete a survey about the state of their cost-conscious care curricula, 39 (14.9%) said that they have a formal curriculum, while 130 (49.8%) said they are working on it, Mitesh Patel, MD, of the Philadelphia VA Medical Center, and colleagues reported. The remaining 92 programs (35.2%) said they neither had a curriculum nor were working on one.

"If GME is going to play a significant role in curtailing the rising cost of healthcare, it must leverage such models to develop more robust teaching and assessment methods and provide faculty development," Patel and the authors wrote. "Programs that have already implemented such curricula should rigorously study its impact on resident and faculty behavior to inform adoption at other institutions."

Perhaps more troubling than the lack of training programs, many program directors believed their faculty did not consistently model cost-conscious behavior.

For their study, the authors used data from an August 2012 survey of the Association of Program Directors in Internal Medicine on the state of cost-conscious care.

Programs that were in the West, were university-based, and that had more residency positions had higher odds of having a cost-conscious care curriculum. Those that had such programs most commonly used didactic teaching and informal discussion. However, 38.5% of programs don't assess their trainees.

How are physicians expected to be more sensitive to the financial costs faced by patients and the health system as a whole if impressionable residents aren't taught to factor these costs into their way of thinking?

MedPageToday is a trusted and reliable source for clinical and policy coverage that directly affects the lives and practices of health care professionals.

Physicians and other healthcare professionals may also receive Continuing Medical Education (CME) and Continuing Education (CE) credits at no cost for participating in MedPage Today-hosted educational activities.